Organization
KID GLOVES SURGICAL SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCENE R MCVAY GILLAM MD (OWNER/MANAGER)
(501) 349-3182
Entity
Organization
Contact information
Practice address
3623 JOHNSON MILL BLVD STE 101, SPRINGDALE, AR 72762-6412
(501) 349-3182
Mailing address
PO BOX 6908, SPRINGDALE, AR 72766-6908
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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